NE IA FCA Camp Scholarship Form

NE IA FCA Camp Scholarship Form
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of birth

MonthDayYear
Date
What FCA huddle are you connected to?
Are you applying for our Sports Camp in Pella or our Discipleship Camp in Mount Vernon?
Select grade will you be going into this Fall if you are applying for the Pella Sports Camp Scholarship
Select grade will you be going into this Fall if you are applying for the Mount Vernon Discipleship Camp Scholarship
Have you regularly attended your school's FCA huddle this year?
Are you on the FCA Student Leadership team this year?
How many years have you been a member of your school's FCA huddle?
Have you attended an FCA sponsored camp before?
Have you received an FCA Camp Scholarship before?
If yes, what was the amount?
If no, what is the amount you are seeking?
Share a little about your experience with FCA. How has FCA huddles or camps affected your walk with Christ?
Other Circumstances
In the space below please describe any circumstances (past, present, or future) that you feel increase your qualification and/or need for a camp scholarship (e.g., family circumstances, academic standing, ministry or other responsibilities; etc.).
Student Signature
Date

MonthDayYear
Date
Guardian/Parent Signature
Guardian/Parent email
example@example.com
Should be Empty:

Other Circumstances